2Department of Public Health and Primary Care, Leiden University Medical Centre

j.n.bouwes_bavinck{at}lumc.nl

Salicylic acid or liquid nitrogen is probably no more effective than a wait and see policy

Chassenet/SPL

Cutaneous warts are common, benign, and usually self limiting papillomas.12 They present in various forms and sizes and are caused by infection with human papillomavirus (HPV).12 The two most common types are common warts (verrucae vulgaris), which usually occur on the hands, and plantar warts (verrucae plantares), which are usually found on the soles of the feet. Between 10% and 30% of primary school children have cutaneous warts, of which two thirds resolve within two years.3 In the linked randomised controlled trial (doi:10.1136/bmj.d3271), Cockayne and colleagues compare the effectiveness of cryotherapy versus salicylic acid for the treatment of plantar warts⇑.4

Treatments have been based on destruction (cryotherapy, photodynamic treatment, pulsed dye laser), keratolysis (salicylic acid), immunostimulation (dinitrochlorobenzene, interferons), or antimitotic effects (bleomycin, fluorouracil).15 A systematic review of topical treatments for cutaneous warts was published in 2006 and updated in 2009 to include subsequent randomised controlled trials.56 The authors identified 78 …